Why is depression common following a stroke?
There are a number of reasons. If someone had a prior history of depression, that can increase the risk of post-stroke depression. For example, if a person loses their independence or ability to do routine activities after a stroke, those changes can impact one’s mental health and lead to depression.
When stroke is a near-fatal event, it can be a traumatic experience for survivors that may trigger a cycle of anxiety and depression. People may feel anxiety from almost dying, or become depressed if they feel like they’re a burden on their family. Part of recovery and treatment is trying to stop this cycle of anxiety and depression.
Can stroke cause physical changes in the brain that trigger depression?
The brain injury itself may alter brain chemistry enough to cause depression, but there isn’t enough science to fully support a consensus. One recent paper found that the left side of the brain, near the language center, was associated with greater odds of developing depression. Other studies have suggested that stroke may disrupt certain pathways in the brain that predispose you to depression.
Is depression also a risk factor for stroke?
Depression itself isn’t a risk factor, but it can be seen as a predictor of stroke because depression can impact a person’s ability to manage more direct risk factors like diabetes or blood pressure, their motivation to exercise, or generally do the things to keep your brain and heart healthy.
Can medications for depression increase a person’s stroke risk?
Generally speaking, no. There is one class of antidepressants, known as selective serotonin reuptake inhibitors, or SSRIs, that has been associated with an increased risk bleeding in the brain, but recent studies have shown that people who take SSRIs were no more likely to have a stroke due to bleeding in the brain than people not taking an SSRI. The benefits of antidepressants on a person’s mental health and improved quality of life far outweighs any bleeding risks.
If someone is on an antipsychotic medication to treat depression and other mental health issues like anxiety, schizophrenia, or post-traumatic stress disorder, those medications are associated with weight gain, which can cause pre-diabetes or full-blown diabetes. These patients need to be particularly vigilant about managing their cardiovascular health because the medications can make it worse, increasing stroke risk.